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Psychosocial > Exam 2 (Ch. 10, 14-17) > Flashcards

Exam 2 (Ch. 10, 14-17) Flashcards

1
Q

Body image

A

One’s sense of the self and one’s body; a multidimensional construct that encompasses perceptions, thoughts, and feelings about the body.

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2
Q

Borderline personality disoder

A

Characterized by instability of interpersonal relationships, self-image, affects, and control over impulses. Manifestations may include frantic efforts to avoid real or imagined abandonment; unstable, intense relationships that alternate between extremes of idealization and devaluation; repetitive self-mutilation or suicide threats; and inappropriate, intense, or uncontrolled anger.

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3
Q

Capitation

A

A uniform payment based on the number of people in the population being served. The health or mental health care provider, or group of providers, accepts responsibility to deliver the health or mental health services needed by all members of a specified group, and an agreed-on payment is made at regular intervals to the provider. The payment is made even if no services have been given, but the payment is no greater than the agreed-on amount if even more extensive services have been provided.

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4
Q

Codependency

A

A term referring to the effects that people who are dependent on alcohol or other substances have on those around them, including the attempts of those people to manage the chemically dependent person. The term implies that the family’s actions tend to perpetuate (enable) the person’s dependence.

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5
Q

Commitment

A

A legal process for admitting, usually involuntarily, a mentally ill person to a psychiatric treatment program. Although the legal definition and procedure vary from state to state, commitment usually requires a court or judicial procedure. Commitment may also be voluntary.

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6
Q

Compulsion

A

Repetitive ritualistic behavior or thoughts, such as frequent hand washing, arranging objects according to a rigid formula, counting, or repeating words silently. The purpose of these behaviors or thoughts is to prevent or reduce distress or to prevent some dreaded event or situation. The person feels driven to perform such actions in response to an obsession or according to rules that must be applied rigidly, even though the behaviors or thoughts are recognized to be excessive or unreasonable. Failure to perform these actions often generates anxiety.

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7
Q

Confabulation

A

The fabrication of false memories, perceptions, or beliefs about the self or the environment as a result of neurological or psychological dysfunction. It is difficult to distinguish confabulation from lies or delusions.

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8
Q

Confidentiality

A

The ethical principle that a physician may not reveal any information disclosed in the course of medical attendance.

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9
Q

Confrontation

A

A communication that deliberately pressures or invites another to self-examine some aspect of his or her behavior in which a discrepancy exists between self-reported and observed behavior. This technique is frequently used in the tx of alcoholism and chemical dependency.

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10
Q

Confusion

A

Disturbed orientation with respect to time, place, person, or situation.

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11
Q

Delusion

A

A false belief based on an incorrect inference about external reality, firmly sustained despite clear evidence to the contrary. The belief is not part of a cultural tradition such as an article of religious faith.

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12
Q

Therapeutic relationship

A

A trusting connection and rapport established between therapist and client through collaboration, communication, therapist empathy and mutual respect.

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13
Q

Therapeutic use of self

A

Being aware of oneself and of the patient and being able to control what one communicates.

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14
Q

3 stages of the therapeutic relationship

A

A) the development of rapport
B) the development of a working relationship
C) the maintenance of a working relationship through goal achievement

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15
Q

Therapeutic qualities

A

Empathy, sensitivity, respect, warmth, genuineness, self-disclosure, specificity, and immediacy

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16
Q

ALOR

A 
Acronym for processing feedback:
Ask
Listen
Observe
Reflect
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17
Q

8 communication techniques

A
  • Make initial contacts brief
  • Choose words carefully
  • Be comfortable with silence
  • Encourage by minimal response
  • Listen and observe
  • Summarize and focus
  • Ask for clarification
  • Follow through on promises
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18
Q

Transference

A

Occurs when the patient unconsciously relates to the therapist as if that person were someone else, usually an important person in the patient’s life.

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19
Q

Countertransference

A

Occurs when the therapist unconsciously relates to the patient as if that person were someone else, usually an important person in the therapist’s life.

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20
Q

3 types of dependence

A
  1. detrimental
  2. constructive
  3. self-dependence
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21
Q

Detrimental dependence

A

Excessive dependence by the patient on the health professional.

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22
Q

Constructive dependence

A

Productive. Pt. relies on the health professional to provide something that the pt. cannot manage.

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23
Q

Self-dependence

A

Ability to depend on oneself, to identify and solve one’s own problems. Synonymous with independence.

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24
Q

Stigma

A

Social disapproval

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25
Q

Issues that arise in therapeutic relationships

A
  1. transference and countertransference
  2. dependence
  3. stigma
  4. helplessness, anger, and depression
  5. sexual feelings
  6. fear and revulsion
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26
Q

Obligations of OT staff toward patients

A
  1. Patient-centered focus
  2. Goal-oriented treatment
  3. Patient’s rights
  4. Confidentiality
  5. Patient welfare
  6. Continuing education
  7. Standard of care
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27
Q

7 Guiding Principles of the OT Code of Ethics

A
  1. Beneficence
  2. Nonmaleficence
  3. Autonomy, confidentiality
  4. Duty
  5. Procedural justice
  6. Veracity
  7. Fidelity
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28
Q

5 important points of the OTPF process

A
  1. the process is dynamic and evolving
  2. context is embedded in our understanding of intervention
  3. clients are individuals, whether they receive services as individuals or as members of groups or populations
  4. the client must be an active participant (client-centered process)
  5. the outcome is engagement in occupation
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29
Q

8 stages in the OT process

A
  1. referral
  2. screening
  3. evaluation
  4. intervention planning
  5. intervention implementation
  6. intervention review
  7. transition planning
  8. discontinuation of services
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30
Q

Referral

A

Request for services

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31
Q

Screening

A

Purpose is to determine whether a person needs OT evaluation or intervention.

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32
Q

Evaluation

A

Purpose is to find out enough about the person to determine the direction of intervention.

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33
Q

Intervention planning

A

Entails identifying the client’s problems, choosing outcomes, and selecting reasonable goals and methods to achieve them.

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34
Q

Intervention implementation

A

The actual performance of the methods and activities outlined in the intervention plan.

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35
Q

Intervention review

A

Process for determining the effectiveness of the plan.

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36
Q

Transition planning

A

Stage in which the next care setting is identified and arrangements are made.

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37
Q

Discontinuation of services

A

Final step in the intervention process. Opportunity for the client and OT staff to review what has transpired over the course of the intervention process.

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38
Q

Holistic perspective and dynamic process of OT (3 key goals)

A

OT intervention is always:

  1. client centered
  2. occupation centered
  3. outcome oriented
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39
Q

Focus of clinical inquery

A

First question: What is the patient’s status?
Second question: What are the available options?
Third question: What ought to be done?

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40
Q

Types of reasoning

A
  1. procedural
  2. interactive
  3. conditioned
  4. narrative
  5. pragmatic
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41
Q

Procedural reasoning

A

Applies to the disability and the treatment options.

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42
Q

Interactive reasoning

A

Applies to understanding and relating to the patient as an individual.

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43
Q

Conditioned reasoning

A

Includes the larger context, the “what if” brainstorming of events that might change the current conditions and the need for the patient to participate.

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44
Q

Narrative reasoning

A

Involves telling a story that will capture interest and spark confidence in the patient.

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45
Q

Pragmatic reasoning

A

Getting things done, thinking through problems that might arise and finding efficient strategies to take care of the details.

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46
Q

Evidence-based practice

A

The reasoned and judicious use of the best evidence to select interventions to meet specific clinical needs.

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47
Q

Levels of evidence

A
  1. meta-analyses and systematic reviews
  2. randomized control trial (RCT)
  3. research studies that do not meet the standard of RCT
  4. expert opinion
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48
Q

Assessment

A

Used to identify specific tests, instruments, interviews, and other measures used in evaluation.

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49
Q

Asset

A

Useful, adaptive behavior, one that helps the client get what they need and carry out daily life activities.

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50
Q

Deficit

A

Behavior that interferes with meeting the client’s needs and doing the things they need and want to do.

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51
Q

Context(s)

A

Conditions that surround and give meaning to occupational functioning.

52
Q

7 types of contexts

A
  1. cultural
  2. physical
  3. social
  4. personal
  5. spiritual
  6. temporal
  7. virtual
53
Q

Cultural context

A

Cultural identifiers: race, ethnicity, family background, beliefs and values, customs, rituals, and traditions.

54
Q

Physical context

A

Includes nonhuman aspects of the environment, such as objects, buildings, structures, natural features, the geography, and sensory elements of the environment.

55
Q

Social context

A

Concerns other people, groups, and organizations with which the person interacts.

56
Q

Personal context

A

Age, gender, education, socioeconomic status.

57
Q

Spiritual context

A

Includes those things that the person believes give life higher meaning and purpose.

58
Q

Temporal context

A

Locates the performance of occupation in time, whether by time of day, time of life, the season, or other time orientation.

59
Q

Virtual context

A

Concerns activities performed in association with technology and occur without physical contact.

60
Q

Performance patterns

A
  1. habits
  2. routines
  3. roles
61
Q

Expected environment

A

Where a patient will be going after discharge.

62
Q

Top-down evaluation

A

Begins with the client’s goals; no other data are collected until the client’s perspective is understood.

63
Q

Bottom-up evaluation

A

Begins with the factors that appear to impede occupational engagement.

64
Q

Environment-first evaluation

A

Appropriate when safety is a factor. Ex: assessing the home environment for an elderly client to reduce risk of falls.

65
Q

Occupational profile

A

Interviews, questionnaires, and casual conversation to provide background on the person’s occupational history and interests, experiences, and goals.

66
Q

Analysis of occupational performance

A

Done once the therapist has a sense of the person’s goals and problems. May require the therapist to use one or more assessments or other measures to identify the performance problems.

67
Q

Assessment of Motor and Process Skills (AMPS)

A

Measures a person’s motor skills and organizational abilities as revealed in familiar household tasks.

68
Q

Establishing service competency

A

When the OT is confident the OTA is skilled in a particular assessment and would obtain the same or very similar results to what the OT would obtain with that instrument.

69
Q

Therapy set

A

An understanding of OT generally and how it will benefit the patient specifically.

70
Q

Observation

A

Process of taking note of behavior or anything else we can take in through our senses.

71
Q

Interpretation or inference

A

Process of giving meaning to what we have observed.

72
Q

Standardization

A

A way of ensuring accuracy and consistency with assessments.

73
Q

Norm referenced

A

An assessment that is norm referenced will provide tables of normative data, which can sometimes be skewed by cultural or other bias. (grading on a curve, aiming to distribute the scores in a normal distribution)

74
Q

Criterion referenced

A

A criterion is a standard against which an individual’s performance is measured. An assessment that is criterion referenced is of reading level. (professor grading students on their achievement of specific competencies)

75
Q

Reliability

A

Represents the consistency of test results when the test is repeated.

76
Q

Interrater reliability

A

Shows the degree to which two people giving the test will obtain similar results.

77
Q

Validity

A

Shows the degree to which the test measures what it says it is measuring.

78
Q

Face validity

A

Tests with fairly obvious validity. Ex: a test of ROM seems to be a valid measure of the degree to which motion occurs at different joints in an individual.

79
Q

Occupational Performance History Interview (OPHI-II)

A

Used to obtain an occupational history, determine how well the person is functioning in occupational roles, and estimate the balance between occupational and leisure activities.

80
Q

The Role Checklist

A

Provides information on occupational roles as perceived by the client; short written inventory that can be completed by people who have basic literacy and intact cognition.

81
Q

The Canadian Occupational Performance Measure (COPM)

A

Structured interview that measures a client’s own perceptions about their own occupational performance.

82
Q

Model of Human Occupation Screening Test (MOHOST)

A

24-item brief assessment covering areas related to occupational participation

83
Q

Comprehensive Occupational Therapy Evaluation (COTE)

A

Most widely used observation checklist. Lists 25 behaviors and provides a scale for rating them. Behaviors are divided into 3 areas: general behavior, interpersonal behavior, and task behaviors.

84
Q

Milwaukee Evaluation of Daily Living Skills (MEDLS)

A

Standardized assessment. Screening form is used to determine which areas of 21 subtests should be tested.

85
Q

The Kohlman Evaluation of Living Skills (KELS)

A

Assesses several skills in the areas of personal care, safety and health, money management, transportation, use of the telephone, and work and leisure.

86
Q

Occupational Questionnaire

A

Assessment of time use. Measures time and volition.

87
Q

Barth Time Construction

A

Assessment of time use. No words, good for illiterate patients.

88
Q

The Bay Area Functional Performance Evaluation (BaFPE)

A

Standardized instrument that assesses some of the general skills needed for independent functioning.

89
Q

Allen Cognitive Level Test (ACL)

A

Uses the client’s performance of progressively more difficult leather-lacing stitches to assess cognitive level.

90
Q

The NPI Interest Checklist

A

Lists 80 activities sorted into categories: manual skills, physical sports, social recreation, activities of daily living, and cultural and educational pursuits

91
Q

Modified Interest Checklist

A

Based on the original NPI. Includes information about participation and future interest in the activities.

92
Q

Adolescent Leisure Interest Profile

A

Assessment of adolescent’s interest in, participation in, and feelings about leisure. Lists 86 activities in a checklist format.

93
Q

Non-stardardized assessments

A

Lacks a set procedure for administration and scoring, clinician must think carefully about the results

94
Q

Kitchen Task Assessment (KTA)

A

Assessment of planning and organizational skills for a person with dementia; might best be conducted in the person’s kitchen at home.

95
Q

Steps in intervention planning

A
  1. Review the results of the individual’s assessment(s) and the evaluation and discuss with client
  2. Identify problems and, if possible, their causes
  3. Identify the person’s strengths and assess/estimate the person’s readiness and motivation for intervention
  4. Collaborate with the client to set goals (LTG and STG, in order of priority)
  5. Identify intervention principles using the practice model
  6. Select methods appropriate to the practice model
96
Q

Long-term goal

A

States the functional outcome or destination of the intervention.

97
Q

Short-term goal

A

Can be understood as small steps to achieve the LTG; synonymous with ‘objective’

98
Q

Treatment or functional restoration (category of intervention)

A

Aims to alter the underlying disease process; the principles and techniques of sensory integration fit into this category.

99
Q

Maintenance of function (category of intervention)

A

Aimed at assisting the person to use their remaining capabilities; often the focus of programs for individuals with chronic or progressive disorders, such as schizophrenia and organic mental disorders.

100
Q

Rehabilitation (category of intervention)

A

Focuses on restoring the person’s ability to function after the disease process has been medically treated.

101
Q

Residual disability

A

The loss of function due to disease.

102
Q

Habilitation

A

Distinguishes intervention for clients who never developed these functional abilities because they became ill at a young age.

103
Q

Prevention

A

Aims to intervene before dysfunction occurs.

104
Q

RUMBA

A 
Relevant
Understandable
Measurable
Behavioral
Achievable
105
Q

Making goals measurable and time limited

A

Measure: frequency, duration, level of accuracy, number of times, level of assistance needed

Time frame: by specific date, by end of specific unit of time, after a specified number of sessions, by a known milestone

106
Q

Environmental demand

A

An expectation for a certain kind of behavior or action that is evoked by something in the environment.

107
Q

Environmental support

A

A feature of the environment that encourages and assists the individual to perform a particular behavior.

108
Q

Who reads charts?

A
  • Treatment team
  • Documentation reviewers
  • Third-party payers and reimbursement reviewers
  • Accrediting agencies
  • Consumers
  • Legal system
  • Researchers
109
Q

Continuous Quality Improvement (CQI)

A

Quality management process; CQI monitoring is ongoing (constant) rather than retrospective (looking back); more interdisciplinary than QA and looks at outcomes (results) rather than problems; more client centered than system centered

110
Q

Quality Assurance (QA)

A

Systematic approach to the evaluation of patient care that enables the identification, assessment, and resolution of problems in order to improve health care benefits for patients

111
Q

The OT Seeker

A

Database available at OTseeker.com and gives OT practitioners access to a range of studies that may be useful in choosing or recommending various approaches; Occupational Therapy Systematic Evaluation of Evidence

112
Q

Sensory defensiveness screening

A

Screening for SD, which is a negative reaction to one or more types of sensations (such as touch, movement, sound, taste/texture, or smell), often requiring you to control their daily routine to avoid such things.

113
Q

Priority

A

Importance or urgency of goal

114
Q

Documentation checklist

A
  • Black ink
  • Write legibly
  • Date entry
  • Sign entry
  • Indicate errors
  • Include patient’s name and case no.
  • Document ph. contact
  • Document outcome of contact and the plan
  • Document immediately or ASAP
  • Will 3rd party payer understand?
  • Think about reading entry in court
115
Q

Rules for note writing

A
  • Record observations, not interpretations
  • Avoid judgmental language
  • Avoid jargon
  • Omit extraneous detail
  • Be brief
116
Q

Contact note, treatment note, or visit note

A

Document a single contact or visit, such as a phone call or tx session

117
Q

Progress note

A

Document tx and changes in the patient’s condition since the last note

118
Q

Discontinuation or discharge note

A

Reviews the entire course of the person’s treatment

119
Q

Transitional note

A

Written in preparation for a move from one setting to another

120
Q

Reevaluation note

A

Documents the results of the reevaluation, compares these to the initial evaluation, and recommends changes or continuations in the plan

121
Q

Intervention plan

A

Spells out the goals established, the methods to be used, the frequency of treatment, and the time by which the therapist expects the goals to be reached

122
Q

Day programs

A

Provides services in the community and may be loosely structured and collaborative in its work with clients

123
Q

Vocational rehab

A

Programs that aim to develop the ability to function in a job or joblike situation

124
Q

Transitional services

A

Prepare patients to move from the hospital to the community

125
Q

Crisis intervention

A

Practice model that aims to help people cope in the midst of crisis

Psychosocial (3 decks)

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